Abstract

Angiogenesis is a critical component of the initiation, maintenance and progression of tumors, and has been the target of extensive drug development. In clinical practice there are several approved and investigational anti-angiogenesis drugs, the majority of which primarily target the VEGF pathway, however their long term effectiveness remains limited. In designing new drug regimens, it is important to consider other known angiogenic factors that likely contribute to the pro-angiogenic phenotype. We evaluated two such factors: thymidine phosphorylase (TP) (aka platelet-derived endothelial cell growth factor, PD-ECGF), an enzyme that can stimulate endothelial cell migration, and angiopoietin 2 (Ang2), a member of the Ang/Tie2 signaling pathway. To target TP, we used a novel, highly specific, orally available small molecule inhibitor, which we had previously designed, named AEAC. To target Ang2, we used an Ang2 neutralizing peptibody, L1-7[N] (provided by CTEP-NCI), which is a genetically engineered peptide-Fc fusion protein that specifically binds Ang2. In a mouse NCI-H460 NSCLC sc xenograft model, AEAC and L1-7[N] produced 33% and 67% reductions, respectively, in tumor growth, and the combination produced a small, but statistically significant further reduction, when compared to either agent used alone. Tumor growth inhibition was paralleled by a reduction in Ki-67 staining. L1-7[N] also produced a large infiltration of macrophages (F4/80+) into the tumors after treatment. We also tested the drug combination in a mouse genetic model of pancreatic neuroendocrine tumors (PNET). PNET are one the few human solid tumors that are clinically responsive to angiogenesis inhibitors used alone. These mice have a conditional knockout of the Men1 gene in the endocrine pancreatic cells (Pdx1-Cre;Men1 mice) mimicking a primary genetic alteration seen in human disease. Men1 KO PNET experiments were initiated when the mice were 10-11 months old, and drug treatment was daily (5 days per week) for 3 weeks. To date, we have not seen any antiangiogenic or antitumor effects of the drugs. Upon sacrifice, the mice were found to have extensive insulinomas, involving around 70% of the entire pancreas. CD31(+) and F4/80(+) cells in the pancreas showed that most of them concentrated inside the PNET, however there was no change after the treatments. Studies are currently underway to determine if higher doses and/or starting treatment at an earlier time would be more efficacious.